short 4th / 5th metacarpal
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/7/0/44d896ef673a5cb39402d41e25eed7_big_gallery_thumb.jpg)
Positive
metacarpal sign • Positive metacarpal sign - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/7/5/dea3dff0ecaa1e442618c1f3e9738d_big_gallery_thumb.jpg)
Shortening of
the fourth/fifth metacarpals • Short 4th metacarpal - post-traumatic - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/7/6/f5f0a71c4cc68c9a522e9d257b1f85_big_gallery_thumb.jpg)
Shortening of
the fourth/fifth metacarpals • Negative metacarpal sign - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/7/2/9b79a3f9de56943d1195cc089032f0_big_gallery_thumb.jpg)
Positive
metacarpal sign • Short 4th and 5th metacarpals - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/7/7/192fc110611d52497ce2fcc33d1d20_big_gallery_thumb.jpg)
Shortening of
the fourth/fifth metacarpals • Short 5th metacarpal - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/0/2/5/1/c60c01bf29984e7d75092c266732cd_big_gallery_thumb.jpg)
Madelung
deformity • Turner's syndrome - hand - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/7/1/b36b3c0e76fe0dac6ae90085d0ac7a_big_gallery_thumb.jpg)
Positive
metacarpal sign • Turner syndrome - hand - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/7/8/38a4be8e503ca44dd8811be5afea05_big_gallery_thumb.jpg)
Shortening of
the fourth/fifth metacarpals • Bilateral short fifth metacarpals - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/7/9/d22abaf89e1278aa0b0a9dc54cbd94_big_gallery_thumb.jpg)
Shortening of
the fourth/fifth metacarpals • Short fourth metacarpal - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/8/0/dca606a1a3f88ffb8beada211943e1_big_gallery_thumb.jpg)
Shortening of
the fourth/fifth metacarpals • Short 4th/5th metacarpal - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/8/1/b08b6a9f25d071a2d3a42612ba8308_big_gallery_thumb.jpg)
Shortening of
the fourth/fifth metacarpals • Short 5th metacarpal - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/8/2/11_big_gallery_thumb.jpg)
Shortening of
the fourth/fifth metacarpals • Shortening of metacarpal bones - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/8/3/11_big_gallery_thumb.jpg)
Shortening of
the fourth/fifth metacarpals • Short 5th metacarpal - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/7/3/k2_big_gallery_thumb.jpg)
Positive
metacarpal sign • Brachymetacarpia - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/1/4/4/7/4/IMG_20210811_125438_big_gallery_thumb.jpg)
Positive
metacarpal sign • Positive metacarpal sign - Ganzer Fall bei Radiopaedia
![](https://pacs.de/sites/default/files/pictures/thumbs/data.pacs.de/1/2/8/5/6/7/148c218992a91f750c6a4e4044435ccf7f017ca87d3bc3997fc786f145d98544_big_gallery_thumb.jpg)
Brachydactyly
• Turner syndrome - short fourth and fifth metacarpals, brachydactyly & clinodactyly - Ganzer Fall bei Radiopaedia
Shortening of the fourth/fifth metacarpals and less commonly metatarsals is seen in a variety of apparently disparate conditions.
Pathology
Etiology
Common causes :
- idiopathic
- post-infective (e.g. osteomyelitis, yaws, tuberculosis dactylitis)
- pseudohypoparathyroidism/pseudopseudohypoparathyroidism
- post-traumatic (acute or chronic/healed and particularly those involving growth plate)
- Turner syndrome
Uncommon causes :
- basal cell nevus syndrome (Gorlin syndrome)
- hereditary multiple exostosis syndrome
- juvenile idiopathic arthritis
- sickle cell disease with secondary infarction
- homocystinuria
- Langer-Giedion syndrome
Isolated shortening of the 5metacarpals has been recently described in a familial variant of type 1 diabetes mellitus .
Radiographic features
Plain radiograph
Hand x-rays readily identify the abnormality and can be assessed by drawing a line along the heads of the 4 and 5 metacarpals. If this line intersects the head of the 3 metacarpal then shortening is deemed to be present.
Thus, shortened 4 metacarpal is the key to this finding. It is known as the metacarpal sign. It is important to note that a positive sign can be seen in up to 10% of normal individuals .
Siehe auch:
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